OBJECTIVES: With the loss of exclusivity of biologics for the treatment of rheumatoid arthritis (RA), biosimilars represent a potentially more cost-effective treatment option. However, physicians treating RA have demonstrated reluctance to switch, with some holding negative perceptions relative to biologics. This study aimed to assess which policy instruments are most effective in encouraging uptake of biosimilars.

METHODS: Country trends in biosimilar prescribing in RA in EU5 countries from September 2017 to December 2019 were identified through a review of physician prescribing data, obtained from patient record forms completed by physicians who participated in Research Partnership’s quarterly ‘Therapy Watch’ survey. These data were reviewed alongside individual country policies designed to promote biosimilar use, to allow for comparison of the effectiveness of different instruments at achieving their objectives of realising the potential cost-savings associated with the prescribing of biosimilars over originator biologics.

RESULTS: Prescribing data showed a wide range of biosimilar penetration across the five countries, from 37% in Spain and Italy to 75% in the UK (December 2019). These differences can be explained in part by different policy levers being employed across the countries, with the UK having done more than other countries to incentivise biosimilar prescribing. All three countries with the highest biosimilar use (UK, Germany and France), have some form of gain-sharing agreement in place.

CONCLUSIONS: Perceptual barriers to greater uptake of biosimilars still exist across all EU5 countries. While results show multiple policy instruments are contributing to biosimilar uptake, the highest levels of biosimilar penetration in countries with gain-sharing agreements suggest that such policies are particularly effective in motivating prescribers to use biosimilars.